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Osteoarthritis

Definition

Osteoarthritis is a progressive, degenerative joint disease characterized by chronic inflammation of the joint lining. People with osteoarthritis usually have joint pain and limited movement of the affected joint.

Causes

Healthy cartilage is a cushion between the bones in a joint. With osteoarthritis, the cartilage wears away over a long period of time, causing bones to rub together. The exact cause is unclear, but it may be a combination of genetics and the environment.

Risk Factors

Osteoarthritis is more common in older adults. Factors that may increase your chance of osteoarthritis include:

Treatment

There is no treatment that stops cartilage loss or repairs damaged cartilage or bones of the joint. When cartilage wears away, bone on bone friction causes pain and inflammation. The goal of treatment is to reduce joint pain and inflammation, and to improve joint function.

Options may include:

Weight Reduction

Losing weight
can lessen the stress on joints affected by osteoarthritis. The more weight lost, the greater the benefit.
Consider talking to a dietitian who can help you with meal planning.

Exercise and Physical Therapy

Strengthening the muscles supporting an arthritic joint (particularly the knee, lower back, and neck) may decrease pain and absorb energy around the joint. For example, if you have arthritis in the knee, exercise and
strength training
can also help improve knee function.
Swimming and water aerobics are good options. They do not put stress on the joint.

Another option is transcutaneous electrical nerve stimulation (TENS). With TENS, you are connected to a machine. The machine sends electrical signals through the skin to nerves. This type of therapy may decrease pain in some people.

If you have knee osteoarthritis, manual therapy, including
massage therapy
and manipulation, may be helpful.

Medications

Medications may include:

Nonsteroidal anti-inflammatory drugs (NSAIDs)

Cyclooxgenase-2 (COX-2) inhibitors

Topical pain medications that are applied to the skin

Antidepressants

Opioids and similar medications

Viscosupplementation injection

Corticosteroid injection

Heat and Ice

Applying heat with hot water bottles, warm soaks, paraffin, or heating pads helps joints and muscles move more easily. It can also lessen pain. Using ice packs after activity can also help.

Dietary Supplements

Glucosamine
and
chondroitin
are two commonly used supplements. But, research has shown that these are not beneficial for most people with osteoarthritis. Talk with your doctor before taking any herbs or supplements.

Mechanical Aids and Assistive Devices

Shoes with shock-absorbing
in
soles may provide some relief while you are doing daily activities or exercising. Splints or braces help to properly align joints and distribute weight. Knee and wrist joints may benefit from elastic supports.
Canes,
crutches,
walkers, and orthopedic shoes can help with advanced osteoarthritis in the lower body.

If you are having difficulty getting around due to arthritis pain, your doctor might recommend that you install handrails and grips throughout your home. These are useful in the bathroom and shower. You may need elevated seats, including
toilet seats, if you're having difficulty rising after sitting.

Alternative Treatments

Some doctors report that
acupuncture
has been successful in reducing the pain of osteoarthritis. However, the evidence is not consistent.

Surgery

Surgery may be needed for joints with severe damage. It may be done to remove loose pieces of bone or cartilage from joints or reposition bones to redistribute stress on the joint. Some may need to have the joint replaced with an artificial joint.

Prevention

To help reduce your chance of osteoarthritis:

Maintain a healthy weight.

Do regular, gentle exercise, such as walking, stretching, swimming, or yoga.

Avoid repetitive motions and risky activities that may contribute to joint injury, especially after age 40.

With advancing age, certain activities may have to be stopped or modified. It is important to continue to be active, so find an activity that suits you.

Revision Information

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

Hochberg MC, Altman RD, et al. American College of Rheumatology 2012 recommendations for the use of nonpharmacologic and pharmacologic therapies in osteoarthritis of the hand, hip, and knee. Arthritis Care Res (Hoboken). 2012;64(4):465-474.

Living with arthritis. Arthritis Foundation
website. Available at:
http://www.arthritistoday.org/about-arthritis/types-of-arthritis/osteoarthritis.
Accessed June 29, 2015.

Osteoarthritis. National Institute of Arthritis and Musculoskeletal and Skin Disorders website. Available at:
http://www.niams.nih.gov/Health%5FInfo/Osteoarthritis/default.asp. Updated April 2015. Accessed June 29, 2015.